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Health Bill [Lords]

I would say quite the reverse. The introduction of payments could help patients to secure their fundamental rights, particularly those that I mentioned earlier, as set out in the NHS constitution. I hear what the hon. Gentleman is saying, however, and there is a need to proceed cautiously. I looked at the issue when I was Minister of State in the Department, and I felt that although the idea had merit, there was a need to proceed cautiously. However, that is exactly what the Department is doing, with a programme of 70 pilots beginning next year. So we will listen carefully and work cautiously. The Minister of State, Department of Health, my hon. Friend the Member for Corby (Phil Hope) has done such good work in social care to unlock the benefits for patients of having more control over their care, and we now feel that there is merit in proceeding in this direction, especially when we can bring the two budgets together for people with particularly complex health and social care needs. We are not being prescriptive nationally about how and where personal health budgets or direct payments should be used. Many of the primary care trusts that have applied to join the pilot programme believe that the arrangements could have the greatest impact for people with long-term conditions or mental health needs, but a range of innovative ideas is under consideration. However, we have set out a clear policy framework and guiding principles for how all types of personal budget will operate. Any budget should be spent on goods and services agreed in a care plan on which it is appropriate for the NHS to spend money, and there should be high quality advice and support to help people to manage their budgets properly. In the case of direct payments, the Bill and subsequent regulations will provide explicit safeguards. There will also be a robust evaluation to assess how personal budgets and direct payments can best improve the quality of care for patients.